Provider Demographics
NPI:1396195749
Name:ANTON O. KRIS, MD, PC
Entity Type:Organization
Organization Name:ANTON O. KRIS, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTON
Authorized Official - Middle Name:O
Authorized Official - Last Name:KRIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:617-876-0357
Mailing Address - Street 1:16 CHANNING PL
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02138-3307
Mailing Address - Country:US
Mailing Address - Phone:617-876-0357
Mailing Address - Fax:
Practice Address - Street 1:16 CHANNING PL
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02138-3307
Practice Address - Country:US
Practice Address - Phone:617-876-0357
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-16
Last Update Date:2016-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA26449102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalystGroup - Single Specialty